Tsuge was born in Tokyo in 1937, and debuted as a manga creator in 1954. He began making his own comics after being "influenced by the realistic and gritty rental manga of Yoshihiro Tatsumi." He also briefly assisted Shigeru Mizuki in the 1960s.

Tsuge was a pioneer of gekiga ("dramatic pictures") comics, a genre named by Yoshihiro Tatsumi in 1957 to describe an alternative style of manga that stresses realism and is aimed at adults. Tsuge is perhaps best known for his 1968 manga Nejishiki ("Screw-Style"), a surreal story about a man wandering a desolate, post-war Japan. He is considered the originator of the "I-novel" method of comics making. He had not published any new works since 1987.

Tsuge was nominated for the Best Album Award at Angoulême International Comics Festival in 2005, and won the Japan Cartoonists Association's Grand Award in 2017 for Yume to Tabi no Sekai. He was again nominated for an award at Angoulême International Comics Festival in 2019.

Drawn & Quarterly is releasing the complete works of Tsuge in a seven-volume set translated by Ryan Holmberg.

Teruo Ishii directed a live-action film adaptation of Nejishiki in 1998. Panik House released the film in North America under the title Screwed.

Tsuge's "Ame no Naka no Yokujō" (Lust in the Rain) manga short story also inspired a live-action film that opened in November 2024.

Most recently, Tsuge's manga short stories "Scenes from the Seaside" ("Umibe no Jokei") and "Master Ben of the Honyara Cave" ("Hanyara-Dō no Ben-san") inspired the live-action film Tabi to Hibi (Travels and Daily Life), which opened throughout Japan on November 7.

Sources: Chikuma Shobo's X/Twitter account, Oricon News